RESUMO
Free-roaming domestic dogs (FRDD), as vectors of zoonotic diseases, are of high relevance for public health. Understanding roaming patterns of dogs can help to design disease control programs and disease transmission simulation models. Studies on GPS tracking of dogs report stark differences in recording periods. So far, there is no accepted number of days required to capture a representative home range (HR) of FRDD. The objective of this study was to evaluate changes in HR size and shape over time of FRDD living in Chad, Guatemala, Indonesia and Uganda and identify the period required to capture stable HR values. Dogs were collared with GPS units, leading to a total of 46 datasets with, at least, 19 recorded days. For each animal and recorded day, HR sizes were estimated using the Biased Random Bridge method and percentages of daily change in size and shape calculated and taken as metrics. The analysis revealed that the required number of days differed substantially between individuals, isopleths, and countries, with the extended HR (95% isopleth value) requiring a longer recording period. To reach a stable HR size and shape values for 75% of the dogs, 26 and 21 days, respectively, were sufficient. However, certain dogs required more extended observational periods.
Assuntos
Comportamento de Retorno ao Território Vital , Saúde Pública , Animais , Cães , Indonésia , Guatemala , ChadeRESUMO
What explains the underlying causes of rural-urban differentials in severe acute malnutrition (SAM) among under-five children is poorly exploited, operationalized, studied and understood in low- and middle-income countries (LMIC). We decomposed the rural-urban inequalities in the associated factors of SAM while controlling for individual, household, and neighbourhood factors using datasets from successive demographic and health survey conducted between 2010 and 2018 in 51 LMIC. The data consisted of 532,680 under-five children nested within 55,823 neighbourhoods across the 51 countries. We applied the Blinder-Oaxaca decomposition technique to quantify the contribution of various associated factors to the observed rural-urban disparities in SAM. In all, 69% of the children lived in rural areas, ranging from 16% in Gabon to 81% in Chad. The overall prevalence of SAM among rural children was 4.8% compared with 4.2% among urban children. SAM prevalence in rural areas was highest in Timor-Leste (11.1%) while the highest urban prevalence was in Honduras (8.5%). Nine countries had statistically significant pro-rural (significantly higher odds of SAM in rural areas) inequality while only Tajikistan and Malawi showed statistically significant pro-urban inequality (p < 0.05). Overall, neighbourhood socioeconomic status, wealth index, toilet types and sources of drinking water were the most significant contributors to pro-rural inequalities. Other contributors to the pro-rural inequalities are birth weight, maternal age and maternal education. Pro-urban inequalities were mostly affected by neighbourhood socioeconomic status and wealth index. Having SAM among under-five children was explained by the individual-, household- and neighbourhood-level factors. However, we found variations in the contributions of these factors. The rural-urban dichotomy in the prevalence of SAM was generally significant with higher odds found in the rural areas. Our findings suggest the need for urgent intervention on child nutrition in the rural areas of most LMIC.
Assuntos
Disparidades nos Níveis de Saúde , População Rural/estatística & dados numéricos , Desnutrição Aguda Grave/epidemiologia , População Urbana/estatística & dados numéricos , Chade , Pré-Escolar , Países em Desenvolvimento/estatística & dados numéricos , Feminino , Gabão , Honduras , Humanos , Malaui , Masculino , Fatores Socioeconômicos , TadjiquistãoRESUMO
PURPOSE: Safe perioperative care remains a large public healthcare problem in low- and middle-income countries. Anesthesia care provided by trained professionals is one of the essential determinants to address this situation. This article reports the design and implementation of a focused anesthesia educational program for nurses in Chad. METHOD: This program consisted of four full-time courses of one month each, taught in a local hospital. The program included supervised practice in the operating room and post-anesthesia recovery room, skills lab simulation training, high fidelity crisis simulation, theoretical classes, integration sessions, evaluations, and structured feedback sessions. RESULTS: Seven male nurses, aged 28-40 yr, were accepted and successfully completed the program. The median [interquartile range] students' global satisfaction with the program was high (86 [85-93]%). Cognitive and skills assessment improved significantly after the program. Students subsequently worked in city and district hospitals performing essential and emergency surgical interventions. CONCLUSIONS: This is a novel south-south academic cooperation program for nurses in Chad. The program evaluation indicated a high level of satisfaction, effective cognitive and skills learning, and changes in clinical behaviour. Addressing the lack of adequate provision of anesthesia care is a task still to be faced, and this program depicts a bridge alternative until formal educational programs are implemented in the country.
RéSUMé: OBJECTIF: Des soins périopératoires sécuritaires demeurent un important problème de santé publique dans les pays à faible et à moyen revenu. Les soins anesthésiques offerts par des professionnels formés constituent l'un des éléments déterminants essentiels pour régler le problème. Cet article rapporte la conception et la mise en Åuvre d'un programme spécialisé de formation en anesthésie s'adressant au personnel infirmier au Tchad. MéTHODE: Ce programme était composé de quatre cours intensifs d'une durée d'un mois chacun, donnés dans un hôpital local. Le programme comportait une pratique supervisée en salle d'opération et en salle de réveil, des séances pratiques en laboratoire de simulation, une simulation de crise haute fidélité, des classes théoriques, des séances d'intégration, des évaluations et des séances de rétroaction structurées. RéSULTATS: Sept infirmiers âgés de 28 à 40 ans ont été acceptés dans le programme et l'ont terminé avec succès. La satisfaction globale moyenne [écart interquartile] des étudiants était élevée (86 [8593] %). L'évaluation cognitive et des connaissances s'est considérablement améliorée après avoir suivi le programme. Les étudiants ont par la suite travaillé dans des hôpitaux de ville et de district réalisant des interventions chirurgicales essentielles et urgentes. CONCLUSION: Il s'agit d'un programme de coopération universitaire sud-sud innovant au Tchad. L'évaluation du programme a indiqué un niveau élevé de satisfaction, un apprentissage efficace au niveau cognitif et des compétences, ainsi que des changements au niveau du comportement clinique. Il reste encore beaucoup de travail pour régler le problème suscité par l'absence d'une offre adéquate de soins anesthésiques, et ce programme décrit une alternative temporaire intéressante jusqu'à ce que des programmes de formation formels soient mis en Åuvre dans ce pays.
Assuntos
Anestesia/normas , Anestesiologia/educação , Educação Continuada em Enfermagem/métodos , Assistência Perioperatória/educação , Adulto , Chade , Competência Clínica , Comportamento Cooperativo , Avaliação Educacional , Humanos , Aprendizagem , Masculino , Enfermeiras e Enfermeiros/normas , Assistência Perioperatória/normas , Treinamento por Simulação/métodosRESUMO
Anesthesiologists from different centers of our country have been involved in an international cooperation program in Chad. this article shows the experience of a group of them, as well as a brief account of the work that different organizations have carried out to reduce the world wide deficit of anesthetists.
Anestesiólogos de distintos centros de nuestro país se han involucrado en un programa de cooperación internacional en Chad. este artículo muestra la experiencia de un grupo de ellos, así como un breve resumen del trabajo que distintas organizaciones han llevado a cabo para disminuir el déficit global de anestesistas.
Assuntos
Humanos , Anestesiologistas , Cooperação Internacional , Chade , ChileAssuntos
Emigração e Imigração/legislação & jurisprudência , Pesquisadores/legislação & jurisprudência , Ciência , Estudantes/legislação & jurisprudência , Viagem/legislação & jurisprudência , Chade , Congressos como Assunto/organização & administração , República Democrática Popular da Coreia , Irã (Geográfico) , Islamismo , Líbia , Pesquisadores/psicologia , Somália , Decisões da Suprema Corte , Síria , Incerteza , Estados Unidos , Venezuela , Recursos Humanos , IêmenRESUMO
Moringa oleifera is a plant that grows in tropical and subtropical areas of the world. Its leaves are rich of nutrients and bioactive compounds. However, several differences are reported in the literature. In this article we performed a nutritional characterization and a phenolic profiling of M. oleifera leaves grown in Chad, Sahrawi refugee camps, and Haiti. In addition, we investigated the presence of salicylic and ferulic acids, two phenolic acids with pharmacological activity, whose presence in M. oleifera leaves has been scarcely investigated so far. Several differences were observed among the samples. Nevertheless, the leaves were rich in protein, minerals, and ß-carotene. Quercetin and kaempferol glycosides were the main phenolic compounds identified in the methanolic extracts. Finally, salicylic and ferulic acids were found in a concentration range of 0.14-0.33 and 6.61-9.69 mg/100 g, respectively. In conclusion, we observed some differences in terms of nutrients and phenolic compounds in M. oleifera leaves grown in different countries. Nevertheless, these leaves are a good and economical source of nutrients for tropical and sub-tropical countries. Furthermore, M. oleifera leaves are a source of flavonoids and phenolic acids, among which salicylic and ferulic acids, and therefore they could be used as nutraceutical and functional ingredients.
Assuntos
Análise de Alimentos , Moringa oleifera/química , Fenóis/química , Folhas de Planta/química , Antioxidantes/química , Chade , Cromatografia Líquida de Alta Pressão , Flavonoides/química , Cromatografia Gasosa-Espectrometria de Massas , Haiti , Extratos Vegetais/químicaRESUMO
PURPOSE: Our aim was to evaluate the peculiarities of military teleradiology on the basis of the large case series collected between January 2006 and December 2010. MATERIALS AND METHODS: We analysed all radiological teleconsultations/telediagnoses requested by theatres of operations: Kosovo, Iraq, Chad, warships Etna (Indian Ocean) and Cavour (earthquake in Haiti), for a total of 1,132 cases. As part of the case series collected in Kosovo (n=827), we evaluated the entire sample of patients transferred to the Celio Military Hospital in Rome following a teleradiological diagnosis (27 examinations analysed). RESULTS: A total of 1,132 radiological examinations were requested (704 military and 428 civilians). Comparison between teleradiology diagnoses and diagnoses made after patient transfer showed almost perfect concordance based on Cohen's Kappa (κ) statistic (92.59% identical diagnoses), with only a small minority of false positive results (two cases, 7.4%). CONCLUSIONS: The use of teleradiology by the Military Medical Corps helped attain an accurate diagnosis in almost all cases, significantly reducing diagnostic errors and limiting transfers from theatres of operation to cases genuinely necessitating transfer.
Assuntos
Medicina Militar , Telerradiologia/estatística & dados numéricos , Chade , Haiti , Humanos , Iraque , Itália , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Navios , IugosláviaRESUMO
The purpose of this study was to identify caregiver characteristics that influence child nutritional status in rural Chad, when controlling for socioeconomic factors. Variables were classified according to the categories of a UNICEF model of care: caregiving behaviors, household food security, food and economic resources and resources for care and health resources. Sixty-four households with 98 children from ages 12 to 71 mo were part of this study. Caregivers were interviewed to collect information on number of pregnancies, child feeding and health practices, influence on decisions regarding child health and feeding, overall satisfaction with life, social support, workload, income, use of income, and household food expenditures and consumption. Household heads were questioned about household food production and other economic resources. Caregiver and household variables were classified as two sets of variables, and separate regression models were run for each of the two sets. Significant predictors of height-for-age were then combined in the same regression model. Caregiver influence on child-feeding decisions, level of satisfaction with life, willingness to seek advice during child illnesses, and the number of individuals available to assist with domestic tasks were the caregiver factors associated with children's height-for-age. Socioeconomic factors associated with children's height-for-age were the amount of harvested cereals, the sources of household income and the household being monogamous. When the caregiver and household socioeconomic factors were combined in the same model, they explained 54% of the variance in children's height-for-age, and their regression coefficients did not change or only slightly increased, except for caregiver's propensity to seek advice during child illnesses, which was no longer significant. These results indicate that caregiver characteristics influence children's nutritional status, even while controlling for the socioeconomic status of the household.
Assuntos
Envelhecimento , Comportamento , Estatura , Cuidadores , Estado Nutricional , População Rural , Agricultura , Chade , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Grão Comestível , Humanos , Lactente , Mães , Análise de Regressão , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: This study examined how maternal influence on child feeding modified the deterioration of child nutritional status in Chad. METHODS: The pattern of height with age was examined in 98 rural Chadian children aged 12 through 71 months from 64 households randomly chosen. RESULTS: Younger children were more stunted than older ones, probably reflecting secular deterioration in weanlings' nutritional status from 1982 to 1987. Children of mothers with influence over child feeding were taller than children of mothers with less influence, but this held only for the youngest children. CONCLUSIONS: Height-for-age can be a useful indicator of recent changes in social and environmental effects on child health. The mother's influence may have buffered the negative impact of socioeconomic conditions on child growth.
Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Comportamento Alimentar , Relações Mãe-Filho , Estado Nutricional , População Rural , Envelhecimento , Estatura , Chade , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Distribuição Aleatória , Análise de Regressão , População Rural/estatística & dados numéricosRESUMO
Development of ecopathological surveys in tropical areas implies adaptation to face the specific problems of these countries (poor substructures, mobility of herds, etc). Solutions are presented using several examples (Brasil, Senegal, Chad).
Assuntos
Doenças dos Animais/epidemiologia , Criação de Animais Domésticos , Animais Domésticos , Países em Desenvolvimento , Clima Tropical , Animais , Brasil/epidemiologia , Chade/epidemiologia , Fatores de Risco , Senegal/epidemiologiaRESUMO
Serologic markers of HCV and HEV were investigated in 74 French soldiers with non-A, non-B hepatitis and in 18 patients involved in an outbreak of non-A,non-B hepatitis in Algeria. Moreover, anti-HCV antibodies were detected in 13 patients with non-A,non-B hepatitis of parenteral origin. HEV antibodies were investigated in 61-65% of patients involved in the 2 enterically transmitted outbreaks of non-A,non-B hepatitis observed in Algeria and Chad. The third cluster of non-A,non-B hepatitis observed in French soldiers serving in French Guyana is more likely to be attributed to malaria prophylactic treatment with Amodiaquine than to a viral origin. HCV infection was observed in 93% of acute or chronic cases associated with blood transfusion or parenteral drug abuse. Among acute cases, none of the soldiers who contracted the disease in Africa or in French Guyana was found to be anti-HCV positive compared to 78% of those who contracted the disease in France. HCV infections resulted in chronic hepatitis in 61% of cases.
Assuntos
Hepacivirus/imunologia , Anticorpos Anti-Hepatite/sangue , Hepatite C/imunologia , Vírus da Hepatite E/imunologia , Hepatite E/imunologia , Militares , Adulto , Argélia/epidemiologia , Chade/epidemiologia , Criança , Surtos de Doenças , Feminino , França/etnologia , Guiana/epidemiologia , Hepatite C/sangue , Hepatite C/epidemiologia , Hepatite E/sangue , Hepatite E/epidemiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
International Conference on Macroeconomics and Health in Countries in Greatest Need. World Health Organization. Office of International Cooperation; 24-26 Jun. 1992
Assuntos
Atenção à Saúde , Financiamento da Assistência à Saúde , Política de Saúde , Economia e Organizações de Saúde , Países em Desenvolvimento , Chade , Mali , BrasilRESUMO
Control and prevention of parasitic disease depends on an adequate knowledge of interactions among factors such as human behavior, the environment, and the life cycles of parasites. Sociocultural factors in large part determine transmission and persistence of parasites. The main determinants are poverty, low educational level, deficiencies in home technologies, high demographic density, and ruralism. Selected interventions designed to improve any of these situations may fail if they are applied in an isolated manner. The holistic implementation of interventions has proved successful in the control and prevention of parasitic infections in several parts of the word. The implementation of several kinds of interventions simultaneously, that is, a holistic approach, combined with an awareness of a society's infrastructure, can produce favorable results. For such an awareness--when it provokes action--can improve the overall quality of life.
Assuntos
Distúrbios Nutricionais/complicações , Doenças Parasitárias/prevenção & controle , Adolescente , Ascaríase/complicações , Ascaríase/epidemiologia , Comportamento/fisiologia , Chade , Doença de Chagas/epidemiologia , Doença de Chagas/transmissão , Criança , Educação Infantil , Pré-Escolar , Países em Desenvolvimento , Dracunculíase/transmissão , Feminino , Guatemala , Infecções por Uncinaria/epidemiologia , Infecções por Uncinaria/prevenção & controle , Humanos , Malária/epidemiologia , Malária/prevenção & controle , Malária/transmissão , Infecções por Nematoides/complicações , Infecções por Nematoides/prevenção & controle , Distúrbios Nutricionais/etiologia , Doenças Parasitárias/epidemiologia , Doenças Parasitárias/transmissão , Plasmodium/efeitos dos fármacos , Áreas de Pobreza , Esquistossomose/transmissão , Fatores SocioeconômicosRESUMO
Polyparasitism appears to be the rule, rather than the exception, both in populations and in individuals in the developing countries of the world. Thus, polyparasitism represents coendemicity in the epidemiologic sense and simultaneous infections in individual patients in the clinical sense. The effects of polyparasitism are often clinically inapparent. In some situations, however, combined infections may exacerbate clinical manifestations. Coexistent infections may also, under some circumstances, suppress disease symptoms. The possibility of either synergistic or antagonistic effects must therefore be considered in planning public-health intervention intervention programs, and the priorities or strategies selected may need to be altered accordingly. There are few available data at present that are suitable for evaluation of the real consequences of polyparasitism, in part because of the many confounding variables involved and the lack of prospective studies. Therefore, future intervention programs should be accompanied by an epidemiologic research component designed to detect clinical or laboratory changes in parasitic and other infections or in host responses.
Assuntos
Países em Desenvolvimento , Distúrbios Nutricionais/complicações , Doenças Parasitárias/epidemiologia , Adolescente , Afeganistão , Ascaríase/sangue , Ascaríase/complicações , Ascaríase/epidemiologia , Chade , Criança , Desenvolvimento Infantil , Pré-Escolar , Egito , Guatemala , Humanos , Lactente , Recém-Nascido , Madagáscar , Malária/complicações , Doenças Parasitárias/complicações , Peru , Esquistossomose/complicações , Tricuríase/sangue , Tricuríase/complicações , Tricuríase/epidemiologiaRESUMO
Frequency distributions, including all of the observed types of combinations of multiple infections with different helminths and protozoa are presented for sample villages of the African Savannah and of the trans-Andean part of Peru. Measurements of correlation between these infections based on properties of the multivariate, multinomial distribution are calculated to show age and sex patterns of association in different population samples. A correlation matrix for combined infections with Dipetalonema perstans, D. streptocerca and Loa loa, in villages in the rain forest of Zaire indicates that there is a statistically significant association between the two species of Dipetalonema and L. loa. There is also a strong association between the numbers of the microfilariae of D. perstans and D. streptocerca in multiply infected individuals. This correlation is strong only in the rain forest; it is insignificant in the other ecological zones of Bas-Zaire included in the study. The data suggest that there may be selective host factors that influence the extent, distribution and the types of multiple infections in a community.
Assuntos
Doenças Parasitárias/epidemiologia , Adolescente , Adulto , Fatores Etários , Chade , Criança , Pré-Escolar , Clima , República Democrática do Congo , Feminino , Helmintíase/complicações , Humanos , Lactente , Masculino , Peru , Infecções por Protozoários/complicações , Fatores SexuaisRESUMO
Parasitic diseases are predominantly rural diseases. They are often associated with poverty, illiteracy, poor sanitation and high risks of exposure to environmental and biological hazards. Because these factors are also essential determinants in the epidemiology of a variety of other infections with quite different etiologies, occurrence of multiple infections in the same people is common. In the tropics, polyparasitism may involve diseases of major public health inportance such as malaria, schistosomiasis, filarial infections, trypanosomiasis, and others. The paper presents data on the frequency and types of multiple infections with different parasitic and other infectious agents for thirteen villages of Chad, Peru and Afghanistan. The age and sex patterns of a number of observed combinations of parasitic and other diseases are shown for different ecological zones. Concomitant infections with up to five species of filarial worms are found in residents of villages in the Congo River Basin of Zaire. The specific types of combinations of these infections vary from place to place and appear to be closely linked to ecological factors.
Assuntos
Doenças Parasitárias/epidemiologia , Afeganistão , Chade , República Democrática do Congo , Ecologia , Métodos Epidemiológicos , Feminino , Filariose/epidemiologia , Humanos , Masculino , Peru , População RuralRESUMO
Microscopic blue-green Spirulina algae, such as have been consumed since ancient times, are algae having a very high protein content (70 p. 100 of dry matter). At present the Spirulina platensis species in the Kanem region in Chad is gathered by primitive methods, sold in the marketplace and consumed by the local population. The Spirulina maxima species exists in a seminatural state in Mexico City, and an industrial pilot plant harvests and produces one ton per day. Both species, Sp. platensis and maxima, can be cultivated in the same way in a controlled synthetic medium in large-area basins. Whether these Spirulina come from a natural medium or synthetic culture basin, harvesting includes the successive stages of concentration, filtration and washing followed by drying done in a conventional manner. The characteristic constituents of Spirulina platensis and Spirulina maxima, in addition to the high protein content, are both nucleic acids that account for about 4 p. 100 of the dry matter and the fatty-acid composition which is saturated C16 and ethylenic C18 substances. Linoleic acid and especially gamma-linolenic acid arecharacteristic of these two species. The unsaponifiable content is made up in particular of sterols such as cholesterol and beta-sitosterol as well as by triterpenic alcohols such as alpha-amyrin.
Assuntos
Cianobactérias , Aminoácidos/análise , Carboidratos/análise , Chade , Cianobactérias/análise , Cianobactérias/crescimento & desenvolvimento , Fibras na Dieta/análise , Proteínas Alimentares , Abastecimento de Alimentos , Lipídeos/análise , México , Minerais/análise , Ácidos Nucleicos/análise , Proteínas de Plantas/análise , Especificidade da EspécieRESUMO
The biological characteristics of Spirulina are reported in this study. The cellular structure and photosynthetic membrane structure of Spirulina (Cyanoschizophyta) were viewed by electron microscopy after freeze-etching. Special characteristics of the alga, its ecological behavior in natural carbonated water and its energetic behaviou in the laboratory cultures are also reported.
Assuntos
Cianobactérias , Chade , Clorofila/metabolismo , Meios de Cultura , Cianobactérias/citologia , Cianobactérias/fisiologia , Metabolismo Energético , Alimentos , Técnica de Congelamento e Réplica , Luz , Membranas/citologia , México , Microscopia Eletrônica , Fotossíntese , Pigmentos Biológicos/metabolismo , Especificidade da EspécieRESUMO
Protein and energy value of 6 samples of "Spirulina" was studied on growing rats in 1972 and 1973. Sample RL 1(Spirulina platensis, originating from Tchad) was grown in artifical conditions in a laboratory. Others samples (Spirulina maxima) were grown in the solar evaporator near Mexico, washed and dried either on heated rollers (MR8, MR13) or by spraying (MA 7, MA10). Sample MA10 D corresponds to sample MA10, bleached by ethanol plus acetone (Baron, 1975). Each Spirulina sample was the only protein source of balanced, starch diets. The diets were supplemented in essential amino acids (E.A.A.) according to the requirements of growing rats (table 1). The ratios [(digestible nitrogen/metabolisable energy (EM] of the Spirulina diets were similar to that of the control diets containing herring meal. The diets were fed to groups of 15 to 17 growing rats. Energy and nitrogen balances were established by the comparative slaughter technique. Blood and muscle samples were taken at slaughter for the determination of free amino acids levels.